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Q: Is it true that drinking alcohol can trigger a seizure? If so, what's the cause: a certain amount or type of alcohol, or just alcohol in general?

— Saul, New Jersey

A: An occasional alcoholic drink is not associated with increased seizure frequency in most people with epilepsy. Most alcohol-induced seizures are actually alcohol withdrawal seizures, which occur between six hours and 72 hours after heavy drinking in people who have abused alcohol for many years. Because some anticonvulsant medications lower a person's tolerance for alcohol, the immediate effect of even one alcoholic drink will be greater in a person with seizures due to the additive effect of alcohol and the anticonvulsant. Two or more drinks under such circumstances can lead rapidly to slurred speech, unsteadiness, and a sense of imbalance — some of the symptoms of alcohol intoxication. For these reasons, people with epilepsy should monitor their alcohol intake

Of course, if one doesn't drink alcohol at all, such precautions are unnecessary. Nonetheless, I don't require total abstinence from my patients as long as they limit their drinking to no more than one drink once or twice a week. If they experience any side effects at all, I urge them to abstain from alcohol entirely.

Richard M. Restak, MD, is clinical professor of neurology at George Washington Hospital University School of Medicine and Health Sciences.